SHANE ROBERT WORTMAN DPM NPI 1245417385

NPI Information

  • NPI: 1245417385
  • Provider Name: SHANE ROBERT WORTMAN, DPM
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 650 JOEL DR
    FORT CAMPBELL, KY
    ZIP 42223
  • Phone: (270) 798-8375

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NPI Details

Shane Robert Wortman, DPM is a foot and ankle surgery podiatrist in Fort Campbell, KY. Shane Robert Wortman, DPM NPI is 1245417385. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

650 JOEL DR
FORT CAMPBELL, KY
ZIP 42223-318
Phone: (270) 798-8375
Fax: (270) 798-8630

The NPI 1245417385 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 1/30/2008 and was last updated on 2/4/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle Surgery285NEBRASKAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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